Provider Demographics
NPI:1598228413
Name:GOBERT, CHRISTOPHER JUDE
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JUDE
Last Name:GOBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 SILVERTON DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4199
Mailing Address - Country:US
Mailing Address - Phone:770-895-7050
Mailing Address - Fax:
Practice Address - Street 1:460 SILVERTON DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4199
Practice Address - Country:US
Practice Address - Phone:770-895-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies